Five minutes with Dr Mark Lawrence

FIVE MINUTES

Mark tramping with his whānau in the Routeburn Valley

with

Dr Mark Lawrence

We introduced you briefly to Dr Mark Lawrence (Te Rarawa, Te Aupōuri, Ngā Puhi) in the last edition of

The Specialist as our newest National Executive member. Mark is a psychiatrist in the Bay of Plenty. We

asked him to share a bit more about himself.

What inspired you to get into your field of medicine?

I always wanted to be a PE teacher, so I completed an undergraduate degree in Physical Education at the University of Otago. In my last year I decided to apply for medicine through the postgraduate Māori pathway, initially with a view to doing orthopaedics or sports medicine. I worked at Tauranga Hospital as a junior house surgeon, where there was excellent advocacy for more Māori considering psychiatry along with active support for Te ORA Māori Medical Practitioners. Legends in the field included Dr Henry Rongomau Bennett, Tā Mason Durie, Dr Erihana Ryan, and Dr Rees Tapsell to name a few. There was also a strong cohort of young Māori doctors keen to pursue psychiatry at the time, such as Dr Hinemoa Elder, Dr Cameron Lacey, and Dr Thomas Rickard. My fellow junior house surgeon Dr Donna Clarke and I both joined this group. At the time the Ministry of Health supported a scholarship programme which was effective in recruiting more Māori trainees into psychiatry. It provided leadership, mentorship, cultural supervision, and financial support for educational purposes. The rest is history. I would not have survived without this amazing programme. Lastly, I was also concerned about the high rates of mental health problems in Māori so wanted to work in a field of need. I have never looked back!

What are some of the challenging aspects of your job?

One of the biggest challenges of working in psychological health is differentiating normal emotional or psychological response from pathological response to a given circumstance. The threshold between normal and abnormal can be quite blurred at times. He mana tō te kupu! Words have power! The ability to formulate a person’s problem(s) is the art of psychiatry, and the ability to articulate these issues back to the person takes skill. Psychiatry also sits between the interface of respecting the rights of free will/choice and the application of compulsive assessment/ treatments when legal definitions of disorder are met. Applying the Mental Health Act to someone who lacks capacity is often a vexing predicament. The other major challenge is trying to address mental health concerns and presentations precipitated by the social determinants of health. Depression caused by stress of poverty, homelessness and challenging life experiences may respond better to addressing the drivers rather than adding an antidepressant. The health sector has a role in driving social policy and advocacy for our vulnerable populations.

What do you find rewarding about your job?

The flexibility to engage in a range of different roles and understanding that learning is a lifetime journey, not a destination. Psychiatry rewards me with this endeavour. I am one member of our Outpatient Community Adult Team (Clinical). I have an academic role (University of Auckland School of Medicine) with teaching and examining fifth year and trainee interns. I am also on the Board for RANZCP. Despite what the media says, most people do improve and have a good journey through mental health services when they can access